Register to receive information on forthcoming Evening Class and Lunchtime Learning courses offered by Imperial College London

1. About you *

Title (Mr, Ms, Dr, Professor, Sir etc):	*
First Name:	*
Surname:	*
Email address:	*

2. Please indicate one or more of the following (optional):

I am an Imperial College Student
I am an Imperial College Alumnus
I am an Imperial College Member of Staff
I am a student at another institution
I work / study at another Discover South Kensington organisation

I am a resident of the Royal Borough of Kensington and Chelsea
I work for a company based in the Royal Borough of Kensington and Chelsea
None of the above
Prefer not to say

3. Please confirm you would like us to add you to our database so you will receive advance notice of information on the Evening Class and Lunchtime Learning courses organised by Imperial College London. *

Yes